Iron Deficiency In Women Research Articles

The Utility of Hypochromic Markers in the Detection of Latent Iron Deficiency in Women in their First Trimester of Pregnancy

Background and Objectives: While iron deficiency anemia is a documented common problem in pregnancy, there is limited information on latent iron deficiency. Accordingly, we aimed to determine the frequency of the latter in the first trimester of pregnancy and assess the utility of new hypochromic markers in screening for it. Methods: In this cross-sectional study, we recruited 100 pregnant women in their first trimester attending the Maternity Hospital in the period between January and March 2023. Inclusion criteria included hemoglobin >11.0 g/dl, and no iron supplements. Serum ferritin was used to classify patients into latent iron deficiency or iron replete state. While a hematology analyzer was used to determine the new hypochromic markers: namely %Hypo-He, Ret-He, % Hyper-He, RBC-He. Results: The mean age of enrollees was 29.3 (SD 5.5) years and included 38% with latent iron deficiency (hemoglobin > 11 g/dl and S. ferritin ? 30 ng/ml). The latter group had significantly lower hemoglobin (P=0.03), and %Hypo-He (P<0.001) than iron replete women. While neither MCV, MCH, reticulocyte counts, Ret-He, or RBC-He were different. Furthermore, %Hypo-He was significantly negatively correlated with serum ferritin (P<0.001) and had a fair discriminating power between latent iron deficiency and iron replete status. Conclusion: High prevalence of latent iron deficiency was documented among pregnant women in their first trimester; Furthermore, %Hypo-He was a better red cell index to screen for it. Because of its high frequency and anticipated impact on fetal and maternal health, routine screening for latent iron deficiency in pregnancy may be warranted.

High anaemia and iron deficiency prevalence among pregnant women living in low groundwater iron areas of Bangladesh.

Anaemia is a significant public health concern in Bangladesh, yet data on the prevalence of anaemia in pregnancy and the contribution of iron deficiency are limited. Given the reliance on groundwater for drinking, a better understanding of the role of drinking water iron in anaemia aetiology is also required to inform anaemia prevention strategies. This cross-sectional study enrolled 1500 pregnant women from Narayanganj district, Bangladesh, during their second or third trimester. Anaemia and iron status were described and their relationship with drinking water iron assessed using regression analyses. The prevalence of anaemia was 38% (95% confidence interval, CI: 35%, 40%), with 10% (95% CI: 9%, 12%) experiencing moderate-to-severe anaemia. Iron deficiency affected 48% (95% CI: 45%, 50%) of participants. Although drinking water iron concentrations were generally low (median: 0mg/L; interquartile range: 0-1), high concentrations (≥ 2mg/L) were associated with increased ferritin levels but did not significantly impact iron deficiency (95% CI: 0·73, 1·02) or anaemia (95% CI: 0·79, 1·17) prevalence. Iron deficient women had a 1·86 (95% CI: 1·61, 2·15) adjusted prevalence ratio for anaemia and a 4·22 (95% CI: 2·89, 6·17) adjusted prevalence ratio for moderate-to-severe anaemia, compared to iron replete women. Anaemia and iron deficiency are highly prevalent among pregnant women in Narayanganj. These findings challenge the assumption of low iron deficiency prevalence throughout Bangladesh and highlight iron deficiency in pregnancy as a potentially underrecognized public health problem, particularly in regions with low drinking water iron. Further research is needed to clarify the contribution of drinking water iron to iron deficiency and anaemia in Bangladesh. The study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000982819, registered 26/07/2021).

Community screening for iron deficiency in reproductive aged women: Lessons learnt from Australia.

Reproductive-aged women are at an increased risk of developing iron deficiency (ID). We aimed to develop a non-invasive screening tool to identify ID in women and assess the acceptability of screening. We screened women (age 18-49 years) in the community of Western Australia. acceptability of screening, assessed by the feasibility of recruiting the required sample size (n = 323). Hand grip strength, finger prick haemoglobin concentration (Hb), prevalence of heavy menstrual bleeding (HMB), diet, pregnancy history, blood donation, symptoms of ID and history of ID or anaemia (Hb < 120 g/L). Those with Hb <130 g/L and no history of iron therapy in the past 2 years were given referrals for venous full blood count and ferritin sampling. Across 5 days, we recruited 640 eligible women. Of which, 178 (28%) had HMB and 79 (12%) were anaemic. Mean age was 33.5 ± 9.2 years, and mean Hb was 132.4 ± 11.9 g/L. In the past 2 years: 335 (52%) were diagnosed with ID or anaemia; 322 (50%) had taken oral iron; and 210 (33%) had an intravenous iron infusion. Vegetarian diets were followed by 89 (14%); 40 (6%) were regular blood donors; 290 (45%) had a previous pregnancy. HMB increased the risk of symptoms of ID and having prior ID/anaemia diagnosis (67% vs. 47%) or treatment (p < 0.022). Hand grip strength showed a positive relationship with both Hb (adjusted R2 = 0.012, p = 0.004) and ferritin (adjusted R2 = 0.135, p = 0.005). ID screening was well accepted by women in the community, with high recruitment rates over a short period. Future screening tool development may consider incorporating hand grip strength and HMB assessment.

Risk of Iron Deficiency in Women With Endometriosis: A Population-Based Prospective Cohort Study

BackgroundEndometriosis may be linked to the risk of iron deficiency through chronic systemic inflammation or heavy menstrual bleeding. No longitudinal studies, however, have examined the relationship between endometriosis and the risk of iron deficiency. MethodsThis study included 3,294 participants born from 1973 to 1978 and followed as part of the Australian Longitudinal Study on Women's Health from 2000 to 2018. Participants with endometriosis were identified using self-reported longitudinal surveys linked to administrative health records. During each survey, participants were also asked to report the diagnosis of iron deficiency, and we validated diagnoses using an administrative health database. Generalized estimating equations for binary responses with an autoregressive correlation matrix were used to examine the association between endometriosis and the risk of iron deficiency over the seven time points. FindingsWe found that women with endometriosis had a significantly higher risk of iron deficiency than those without endometriosis after adjusting for sociodemographic, lifestyle, reproductive, and nutrition factors (adjusted odds ratio [aOR] = 1.46; 95% confidence interval [CI] [1.29, 1.66]; p < .0001). Women with a surgically confirmed diagnosis and those with clinically suspected endometriosis had a higher risk of iron deficiency (aOR = 1.38; 95% CI [1.17, 1.64] and aOR = 1.53; 95% CI [1.30, 1.81]), respectively. These associations, however, were slightly attenuated (by 8%) when adjusted for the presence of heavy menstrual bleeding. ConclusionsWomen with endometriosis are at a higher risk of developing iron deficiency than those without endometriosis. The findings suggest that iron deficiency should be concomitantly addressed during initial diagnosis and successive management of endometriosis.

An 8-Week Vitamin D3–Fortified Fruit Drink Supplementation Increases Serum Ferritin Concentration: A Randomized Controlled Trial in Malaysian Women With Low Iron Stores

BackgroundThere is limited randomized controlled trial evidence to support the association between vitamin D deficiency and anemia risk, highlighting the necessity for further investigations into the role of vitamin D in influencing iron status. ObjectiveThe aim of this study was to determine the effect of vitamin D3–fortified fruit drink consumption (4,000 IU) on vitamin D and iron status biomarkers among iron-deficient women (serum ferritin of <20 μg/L [to convert μg/L ferritin to ng/mL, multiply by 1]). DesignAn 8-week double-blind randomized controlled trial was conducted. Subjects/settingA total of 45 healthy, nonpregnant, nonlactating subjects aged 18 through 40 years (mean [SD] 25.3 [4.6] years) were included in the study, excluding those who donated blood 6 months prior, regularly consumed nutritional supplements, or had gastrointestinal or iron metabolic disorders. InterventionSubjects were randomly assigned to receive either vitamin D3–fortified fruit drink or a placebo. Main outcome measuresMeasurements of 25-hydroxyvitamin D (25[OH]D), serum ferritin, high-sensitivity C-reactive protein, and full blood count concentrations were obtained at baseline, interim, and post intervention. Statistical analysesA mixed model, repeated measures analysis of variance was used to analyze the intervention effect. ResultsAttrition rate for the study was 13%, with 6 dropouts, and 39 subjects completed the study. Daily consumption of vitamin D3–fortified fruit drink in the intervention group resulted in significant increases in 25(OH)D and serum ferritin concentrations compared with the placebo group. The intervention group showed significantly higher mean (SD) changes (Δ) in both 25(OH)D (Δ 76.4 [30.2] nmol/L [to convert nmol/L 25(OH)D to ng/mL, multiply by .4] vs Δ –1.3 [10.7] nmol/L; P = .001) and serum ferritin concentrations (Δ 2.2 [4.2] μg/L vs Δ –0.3 [3.4] μg/L; P = .048) between baseline and post intervention. The other iron status biomarkers were not affected by the intervention. ConclusionsOur study found that daily vitamin D3–fortified fruit drink supplementation for 8 weeks effectively improved 25(OH)D and iron stores, indicated by increased serum ferritin concentrations, in iron-deficient women. Further research is needed to evaluate its safety, efficacy, feasibility, and optimal food fortification in diverse populations.

The Beneficial Impact of Iron-Fortified Complementary Feeding in the Burden of Iron Deficiency Anaemia (IDA) in Children of Bangladesh

Fortifying food with iron is the most cost-effective way to avoid iron deficiency anemia, a global public health crisis. In addition to choosing the appropriate dietary context for ingestion, it is critical to choose the appropriate iron form and food carrier. Among the increased hazards include low birth weight and preterm delivery. Children with IDA have slower development, worse cognitive performance, and lower levels of physical activity. In women, it also raises the risk of morbidity and death. The amount of iron required in the diet, one&amp;apos;s socioeconomic status, and overall health are all crucial factors to take into account. To combat IDA, a variety of dietary approaches, iron-fortified foods, supplements, and disease management techniques have all been employed. Nowadays, food fortification with iron is seen to be a long-term, sustainable solution. To be effective, the iron fortification program&amp;apos;s food transporters and fortificants must be deemed safe, pleasant, and acceptable by the target population. It also shouldn&amp;apos;t have a detrimental effect on the stability and acceptance of the finished product. This article provides a thorough summary of the current state of iron deficiency in women and children in Bangladesh. This study addresses current issues as well as the efficacy of current therapeutic strategies. Prevention-focused treatments ought to take precedence over treatment-focused ones in high-risk populations. Unknown are the long-term benefits, and unfavorable outcomes are possible. Despite the tremendous progress made, several plans and initiatives are still being supported. These issues are to coverage, quality, and compliance. The findings suggest that iron deficiency and anemia are still major problems in Bangladesh, despite the fact that certain severe deficiencies have been addressed by current intervention efforts. There is a need for more integrated solutions to assist current intervention efforts. Furthermore, new approaches to the management of certain types of iron deficiency anemia are proposed.

Coexistence of multiple causes in patients with iron deficiency.

The etiology of disorders may be attributable to multiple causal factors simultaneously. This study sought to investigate how frequently, and which causes coexist in patients with iron deficiency. All patients who applied to the Iron Deficiency Outpatient Clinic between January and December 2021 were included in this cross-sectional study. The causes of iron deficiency were extracted from patient files. Analyses were conducted on the entire population as well as three subgroups: women of reproductive age, postmenopausal women, and males. Numbers and frequencies of causes of iron deficiency were calculated. The subgroups were compared using the Jamovi software. The study sample comprised a total of 331 patients. Women of reproductive age were the majority of patients admitted to the clinic (86.7%, n=287). Men represented 6.3% of the sample (n=21), and postmenopausal women accounted for 7.0% (n=23). The mean ages were 37.6±9.05, 49.2±15.49 and 57.8±10.84 years, respectively. The overall sample's rate of multiple iron deficiency causes coexisting was 33.5% (n=111) and the subgroups showed similar frequencies for the coexistence of multiple causes. Statistically, the number of simultaneous multiple causes varied between subgroups (χ2=118, df=10, p<0.001). Heavy menstrual bleeding and nonsteroidal anti-inflammatory drug use were the most common dual causes of multiple coexisting conditions (n=46, 41.4%). In terms of the number of causes, the coexistence of two causes of iron deficiency in women was notable, whereas the coexistence of three causes in males was remarkable. Furthermore, it has been found that some patients have up to five coexisting causes of iron deficiency. Some iron deficiency causes may coexist, and this must be taken into account for the effective management of iron deficiency.

Performance Characteristics of Percentage of Hypochromic Red Cells in the Detection of Latent Iron Deficiency in Women with Menometrorrhagia

BACKGROUND&#x0D; Menometrorrhagia is a common cause of iron deficiency anemia (IDA) in women of reproductive age group. Latent iron deficiency (LID) is a precursor stage of IDA in which there is evidence of iron deficiency without anemia. LID causes cognitive impairment, impaired immunity and reduced work capacity which can be corrected by iron supplementation. Conventional biochemical and hematological parameters have limitations in the diagnosis of LID. This study was done to assess the performance characteristics of percentage of hypochromic red cells (% HYPO) in the detection of LID in women with menometrorrhagia.&#x0D; METHODS&#x0D; This study was done on 226 women attending the Gynaecology OP clinic of our institution, of which 183 had menometrorrhagia, and the remaining being controls. After testing for conventional hematological indices and serum ferritin, the subjects were divided into 3 groups: a LID group, an IDA group, and a control group without iron deficiency. ROC curve analysis was performed to assess % HYPO and other conventional hematological parameters in identifying LID.&#x0D; RESULTS&#x0D; Most hematological indices were within normal ranges in LID population, thus limiting their utility. The AUC for % HYPO in LID population was 0.736 with an optimum cut-off of 8.7 corresponding to a sensitivity and specificity of 62.3 and 76.74 respectively.&#x0D; CONCLUSIONS&#x0D; % HYPO is a sensitive, specific, fast, cheap, and practical and thus serves as a better predictive marker than conventional biochemical and hematological parameters in the detection of LID.

Risk prediction of iron deficiency for plasmapheresis donors in China: Development and validation of a prediction model.

The present study aims to evaluate the iron stores in plasmapheresis donors and develop and validate an iron deficiency (ID) risk prediction model for plasmapheresis donors with potential or existing ID. We assessed plasmapheresis donors' serum ferritin (SF) and haemoglobin (Hb) levels. The candidate factors showing significant differences in the multivariate logistic regression analysis were used to establish a risk prediction scoring system. The participants were divided into a training cohort and an internal validation cohort in a 7:3 ratio. Additional plasmapheresis donors from a different station were recruited for external validation. The SF levels in both male and female donors in the high-frequency group were significantly lower than those of new donors (male: p < 0.001; female: p = 0.008). The prevalence of ID in female regular donors with a high frequency was significantly higher than that in new donors (33.1% vs. 24.6%; odds ratio = 1.209 [95% CI: 1.035-1.412]). Donation frequency, age, Hb, body mass index and being pre-menopausal were identified as independent risk factors for ID (p < 0.05). The developed model exhibited good discrimination ability (area under the receiver operating characteristic curve >0.7) and calibration (p > 0.05) in development, internal validation cohorts and external validation cohorts. A higher donation frequency has been associated with reduced SF levels and an increased risk of ID in women. The developed ID risk prediction model demonstrates moderate discriminative power and good model fitting, suggesting its potential clinical utility.

Management of iron deficiency in women of childbearing age with oral iron intolerance: a prospective, randomised, controlled trial of three doses of an iron-whey-protein formulation

BackgroundNutritional deficit and oral iron gastrointestinal intolerance may be a common cause of iron deficiency, which can be managed by pharmacists.AimTo understand the prevalence of iron deficiency in women of childbearing age with a self-reported history of intolerance to oral iron and the tolerability of three doses of an iron-whey-protein formulation in the care of these women.MethodFerritin and haemoglobin levels were documented in women of childbearing age with oral iron gastrointestinal intolerance. In those with iron deficiency (ferritin < 30 µg/L), adherence, gastrointestinal tolerability, ferritin, transferrin saturation and haemoglobin levels were compared between their prior oral iron product and iron-whey-protein microspheres randomised to three doses (14 mg daily, 25 mg daily and 50 mg daily) for 12 weeks.ResultsMost screened women had low iron stores (128 (62.7%); ferritin < 30 µg/L), 65 (31.9%) had moderate to severe iron deficiency (ferritin < 12 µg/L) and 33 (16.2%) had iron deficiency anaemia (ferritin < 30 µg/L, haemoglobin < 12 g/dL). Amongst the 59 women who participated in the prospective clinical study of iron-whey-protein microspheres over 12 weeks, 48 (81.4%) were classified as adherent/persistent and fewer instances of gastrointestinal intolerance were reported (0.59 ± 0.91) when compared to 12 (20.3%) and (4.0 ± 2.2) respectively while taking the prior oral iron (Fisher’s Exact and T-test respectively, both p < 0.001). There was no difference in adherence or tolerability of different iron-whey-protein formulation doses. Ferritin, haemoglobin and energy levels increased significantly over 12 weeks.ConclusionUndiagnosed iron deficiency is common in women of childbearing age with a history of intolerance to oral iron and iron-whey-protein microspheres can improve adherence, GI tolerability, iron stores, haemoglobin and energy levels in these women.Clinical trial registration Clinicaltrials.gov identifier (registration includes full trial protocol): NCT04778072.

Missing Cases of Heavy Menstrual Bleeding when Investigating the Etiology of Iron Deficiency

Due to incorrect answers to simple questions like ``Do you have heavy menstrual bleeding?'', heavy menstrual bleeding, the most prevalent cause of iron deficiency in women, is underdiagnosed. In this retrospective and cross-sectional study, menstruating female patients who applied to the iron deficiency outpatient clinic between April and September 2021 were analyzed. Scores on the picture bleeding assessment chart (PBAC) and complaints of heavy menstrual bleeding were recorded. The chi-square test and confusion matrix were conducted. There were 157 patients in the sample. There were 82 patients who said they did not have heavy menstrual bleeding, while 75 patients said they did ($$\chi^2(1)=19.7$$, $$p&lt;0.001$$). Sixty percent of patients who did not report significant bleeding had a PBAC score greater than 100, with a median score of 184. The Chi-square test revealed a significant difference between complaints of heavy menstrual bleeding (yes/no) and PBAC (normal/high). The negative predictive value was calculated to be 40.2, while the false miss rate was 59.8%. Six out of ten patients who are investigated for iron deficiency and whose primary cause is heavy menstrual bleeding may be overlooked by this query. In such etiologic investigations, much more objective methodologies, such as PBAC, should be applied.

Prevalence of Anemia in Children of India: A State-level Analysis from NFHS-4 and NFHS-5

As per the report of NFHS-5 in India 514 districts have more than 40 per cent prevalence of anemia among the children aged between 6-59 months. The present study analyses the status of anemia prevalence among the children (6-59 months) across states of India using the data from NFHS-4 and 5 factsheets. The study finds that prevalence of anemia in children (6-59 months) has increased for most of the states. The results of pooled OLS regression suggest that prevalence of iron-deficiency in women (age 15-49 years), public health expenditure and proper diet intake by children are important determinants of child anemia prevalence. The latter two factors have negative relation with child anemia prevalence whereas the former one has a positive relation with child anemia.

Sex, lies, and iron deficiency: a call to change ferritin reference ranges.

Iron deficiency is a very common and treatable disorder. Of all the tests available to diagnose iron deficiency, the serum ferritin is the most able to discriminate iron deficiency from other disorders. However, the reference range for ferritin in many laboratories will lead to underdiagnosis of iron deficiency in women. Studies have shown that 30%-50% of healthy women will have no marrow iron stores, so basing ferritin cutoffs on the lowest 2.5% of sampled ferritins is not appropriate. In addition, several lines of evidence suggest the body physiologic ferritin "cutoff" is 50 ng/mL. Work is needed to establish more realistic ferritin ranges to avoid underdiagnosing a readily treatable disorder.

Sensory evaluations of a novel iron and zinc-enriched powder for the potential treatment and prevention of iron deficiency in women of reproductive age.

Iron deficiency (ID) and ID with anaemia (IDA) are serious global health problems that disproportionately affect women aged 15-49 years. Although food fortification is one of the most effective and sustainable ways to combat nutritional deficiencies, iron remains one of the most difficult micronutrients to fortify, given its tendency to react strongly with food constituents. Therefore, it is important to assess the sensory properties of foods fortified with iron to determine the acceptability and palatability in target populations. We aimed to determine the palatability and acceptability of a novel ironand zinc-enriched powder fortified in tap water by conducting sensory evaluations in 35 women of reproductive age using a 9-point hedonic scale, where participants rated the sensory properties of six samples containing different amounts of the active or placebo powder. We found significant differences between samples reconstituted at 1, 2, and 3 g/L for sensory properties, including overall taste. Participants were found to be more willing to drink the mineral-enriched powder when prepared at the lowest concentration (1 g/L) compared to higher concentrations. Our results provide important insight into the sensory qualities of a novel formulation of an ironand zinc-enriched powder for at-home fortification and indicate consumer acceptability in reproductive-aged women, a key group at risk for ID/IDA. If found to improve iron status, novel treatments like this product will contribute to global efforts to develop safe, acceptable and sustainable interventions for ID and IDA.

Replenishment of iron deficiency in women before the use of assisted reproductive technologies

Introduction. Anemia is a major health problem worldwide, increasing the risks of low birth weight, preterm birth, perinatal mortality, stillbirth, postpartum hemorrhage, and maternal mortality. Replenishing iron deficiency at the stage of preconceptional preparation reduces the incidence of IDA and can reduce the incidence of pregnancy complications and improve perinatal outcomes.Aim. To evaluate the effectiveness of ferrous sulfate 80 mg and its potential to replenish iron deficiency in women with infertility before using assisted reproductive technologies (ART).Materials and methods. A prospective clinical longitudinal study was conducted from May to September 2023 at LLC Health Clinic, Moscow. The study included women (n = 34) at the stage of pregnancy planning by IVF with a diagnosed iron deficiency. Iron deficiency was established in accordance with the following criteria: decrease in serum ferritin level less than 30 μg/l, serum iron level less than 15 μmol/l.Results. After 12 weeks of taking ferrous sulfate, the average hemoglobin level increased from 112.3 ± 6.5 (101–119) g/l to 118.5 ± 6.5 (110–133) g/l (W-Wilcoxon 9300 test, p = 0.003), mean serum iron level from 15.4 ± 4.0 (5.7–22.5) μmol/l to 34.8 ± 7.1 (20.1–46.7) μmol/l (Wilcoxon W test 602.0, p &lt; 0.001), mean ferritin level from 8.2 ± 3.1 (4.5–17.0) μg/ml to 37.6 ± 6.7 (30.6–52.6) μg/ml (Wilcoxon W test 595.0, p &lt; 0.001).Conclusions. Timely examination of patients for iron deficiency and iron deficiency anemia at the stage of preconceptional preparation makes it possible to prescribe an effective correction, thereby helping to reduce the risks of complications of pregnancy and childbirth.

Optimizing diagnosis and treatment of iron deficiency and iron deficiency anemia in women and girls of reproductive age: Clinical opinion.

Iron deficiency (ID) is the world's most common disorder and one of the top five causes of years lived with disability. Whereas low serum ferritin is diagnostic of ID, ferritin-an acute phase reactant-may be elevated in inflammatory states and the first trimester of pregnancy even if ID exists. Consequently, in early pregnancy or chronic inflammation, percent transferrin saturation (TSAT) measurement is the best indicator of iron status. Unfortunately, current guidelines do not recommend routine screening for ID in either pregnant or nonpregnant women in the absence of anemia. This circumstance should be urgently reviewed based on available data. While oral formulations have long been the standard for iron replacement therapy and are widely available and inexpensive, oral iron is frequently associated with adverse gastrointestinal effects for the majority-a major reason for poor adherence, inadequate repletion, and persisting ID symptoms and sequellae. Although safe intravenous iron administration was introduced in the mid-1950s, formulations with cores binding the elemental iron more tightly became available in the 2000s, allowing complete and safe replacement, even in a single setting. Prospectively acquired neonatology evidence reports oral iron's failure to reach the developing fetus when the mother is iron deficient. Consequently, while oral iron remains frontline in the first trimester because of insufficient safety data for intravenous iron, the author recommends that the intravenous route should be the gold standard for second-trimester ID when hemoglobin concentrations are less than 10.5 g/dL and for all iron-deficient women in their third trimester.

Iron deficiency and sexual dysfunction in women.

Sexual dysfunction negatively affects approximately 40% to 50% of adult women across various stages of life. Common risk factors include sexual traumas, relationship problems, chronic conditions, medication side effects, and poor physical health, including iron deficiency. This review summarizes a presentation from a symposium that discussed the types and causes of sexual dysfunction at key times in women's lives, focusing on the relationship between iron deficiency and sexual dysfunction. The symposium was held at the XV Annual European Urogynaecological Association Congress, Antibes, France, in October 2022. Symposium content was identified through literature searches of PubMed. Original research, review articles, and Cochrane analyses discussing sexual dysfunction in association with iron deficiency/anemia were included. Iron deficiency in women is commonly caused by abnormal uterine bleeding, but women may develop iron deficiency anemia (IDA) because of increased iron needs or reduced iron intake/absorption. Treatment with oral iron supplementation has been shown to improve sexual function in women with IDA. Ferrous sulphate is considered as a standard of care for oral iron treatment; prolonged-release iron formulations have improved tolerability, enabling lower doses and better tolerability. IDA and sexual dysfunction are related, so the identification of sexual dysfunction or iron deficiency in a woman should prompt an investigation of the other condition. Testing for iron deficiency is an inexpensive and simple step that can be routinely included in the workup of women with sexual dysfunction. Once identified, IDA and sexual dysfunction in women should be treated and followed to optimize quality of life.

The actual speech modules for collecting anamnesis as a foundation of preventive thinking of physician

The article presents information about results of implementation of program of additional education of general practitioners within the framework of cognitive-behavioral prevention of iron deficiency in women. The prospective analysis of level of corresponding awareness and skills of physicians from sample (n=120) and control (n=120) groups before and after training established statistically significant differences in favor of physicians who were trained within the framework of experimental work program that confirms the effectiveness of the last one.

P19-016-23 Risk of Iron Deficiency in Women With Endometriosis: A Population-Based Prospective Cohort Study

P19-016-23 Risk of Iron Deficiency in Women With Endometriosis: A Population-Based Prospective Cohort Study

Effect of dietary factors and time of day on iron absorption from oral iron supplements in iron deficient women.

Guidelines generally recommend taking iron supplements in the morning away from meals and with ascorbic acid (AA) to increase iron absorption. However, there is little direct evidence on the effects of dietary factors and time of day on absorption from iron supplements. In iron-depleted women (n = 34; median serum ferritin 19.4 μg/L), we administered 100 mg iron doses labeled with 54 Fe, 57 Fe, or 58 Fe in each of six different conditions with: (1) water (reference) in the morning; (2) 80 mg AA; (3) 500 mg AA; (4) coffee; (5) breakfast including coffee and orange juice (containing ~90 mg AA); and (6) water in the afternoon. Fractional iron absorption (FIA) from these n = 204 doses was calculated based on erythrocyte incorporation of multiple isotopic labels. Compared to the reference: 80 mg AA increased FIA by 30% (p < .001) but 500 mg AA did not further increase FIA (p = .226); coffee decreased FIA by 54% (p = .004); coffee with breakfast decreased FIA by 66% (p < .001) despite the presence of ~90 mg of AA. Serum hepcidin was higher (p < .001) and FIA was 37% lower (p = .059) in the afternoon compared to the morning. Our data suggest that to maximize efficacy, ferrous iron supplements should be consumed in the morning, away from meals or coffee, and with an AA-rich food or beverage. Compared to consuming a 100 mg iron dose in the morning with coffee or breakfast, consuming it with orange juice alone results in a ~ 4-fold increase in iron absorption, and provides ~20 more mg of absorbed iron per dose. The trial was registered at Clinicaltrials.gov(NCT04074707).